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Individual provider Active NPI

Laura Lea Nofal, PAC

  • Physician Assistant
  • Panama City, FL
National Provider Identifier
1801939137
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105582 Issued in FL
Practice address
801 E 6TH St Ste 604
Panama City, FL 32401-3699
Phone
(850) 804-3845
NPI assigned
Feb 15, 2007
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105582 FL Primary

Addresses

Primary practice location

801 E 6TH St Ste 604
Panama City, FL 32401-3699

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 1

IdentifierTypeStateIssuer
75127331MedicaidFL

Other names 1

  • Laura Lea Brown Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120711000025 FL Practitioner - Physician Assistant 4981708211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.62 of 100Reported as group
Quality
91.75
Promoting interoperability
98
Improvement activities
40
Cost
73.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
004970GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Sacred Heart Health System Inc CurrentSince Mar 1, 2022 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
North Georgia Neurological Clinic PC Past Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

801 E 6th St
Ste 505
Panama City, FL 32401
Phone (850) 804-3030

801 E 6th St
Ste 604
Panama City, FL 32401
Phone (850) 763-8596

Interoperability endpoints

  • Direct secure messaging: laura.nofal.1@9582.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1801939137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST STE 604",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013699",
            "telephone_number": "850-804-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOFAL",
        "first_name": "LAURA",
        "middle_name": "LEA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75127331",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BROWN",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.